Post Acute Care

Why is Post-Acute Care in Pediatrics Important ?

Professionals are conducting various studies, where they analyze children of different ages who undergo different treatments for SHCN (Special Health Care Needs) or even for a major injury.

One such study subjects a 2-year-old child suffering from acute fever. As per the test, the exact reason for the fever could not be determined; hence, a general antibiotic was prescribed; however, the kid developed an acute rash within seven days during the medication period.

A shot of steroids was immediately recommended for the same. Later on, the pediatric doctor diagnosed the issue as a reaction from the antibiotic; hence, the doctor changed the medicine. However, the rash became more severe, even after changing the medication.

Thus, a panel of pediatricians had a meeting to discharge the child without prescribing any further medication.
The patient was supposed to under the observation of In-hospital Post-Acute Care for Children, where the patient would receive long-term care for acute fever. The doctors would decide on the right treatment after they would receive results of the PAC program.

So, below are some facts, based on the above study that concludes why PAC for children is important:

1. The accurate reason for many diseases, such as acute fever, cannot be diagnosed immediately.
2. Children require high-quality care, especially the ones who have complex health conditions, as well as need long-term treatment.
3. After undergoing major surgery, children also need time to heal from the post-surgical complications.
4. Children’s minds are prone to be more adversely affected, as compared to adults, which is why Post-Acute Care in Pediatrics is a necessity.
5. Children with special needs should be kept under constant proper care to gain the confidence to live happily in society.
   
   

Types of Post-Acute Care for Children

After surgery or even after treating a chronic illness, pediatric care for children can be carried out in hospitals, post-acute care centers/rehabilitation centers for children, and residential care for a certain amount of time.

Let’s look at each of these, one-by-one:

1. In-Hospital Post-Acute Care in Pediatrics

Children with special health care needs, and ones who undergo major surgery/treatment, are eligible for such case facility in hospitals. Although there aren’t many PACs in hospitals for children, most of these institutions focus on care for the elderly only; some hospitals have the facility of PAC.

In-Hospital PAC for children is about 45.6% for children ranging from ages 0-13 years. After this, only 5.1% of kids were discharged to home health care, and only 1.1% were discharged to PAC institutions. Out of the 45.6% of kids, 44.5% of children were under neonatal care. It shows that, apart from infants (0-12 months), not many children are subject to PAC in hospitals.

2. Post-Acute/Pediatric Rehabilitation

These centers are for children who show high-intensity signs of pain, trauma, or long-term illness. Some children may be subject to long-term PAC, and others to short-term PAC, depending on the type of illness. Pediatric rehabilitation facilities play a vital role in curbing the negative influence of chronic illnesses in children. It includes specialized outpatient treatment centers, NGOs, and community-based treatment centers.

The APS (American Pain Society) has identified the requirement of such facilities for the following reasons:

• To teach self-management to kids, along with treating their chronic pain illness.
• To teach children methods to cope with long-term health problems.
• Prepare children with severe disabilities to lead a normal life.
• To minimize the post-surgery complications for kids who undergo major surgery/treatment.

3. Residential Pediatric Care

Residential pediatric care is similar to home care for the elderly. It also can be short-term or long-term care, depending on the type of illness.

For children who suffer from permanent chronic pains, residential Post-Acute Care in Pediatrics is a must. Professional individuals or even a group of professionals are assigned to take proper care of children who either undergo a major operation or are subject to long-term treatment for their illness and those diagnosed with permanent disabilities.

Some of the major treatments in such systems include physiotherapy for kids, psychiatry therapy, exercises, following proper medication, and teaching coping mechanisms.

The Outcomes of Short-Term Post-Acute Care in Pediatrics

NCBI derived conclusions from ten studies that were conducted by different institutions. The hospitals provide In-hospital Post-Acute Care in Pediatrics.

Below were the observations:

1. Reduction in Severe Pain: 

The study suggested that a large number of children showed a reduction in the intensity of pain when subjected to short-term pediatric rehabilitation. The timeline for such treatment ranged from 12-24 months.

2. Better Physical Stimuli: 

Children who have permanent disabilities also showed a positive response in terms of physical functions. It is also applicable to kids who undergo major surgery/treatment and choose Post-Acute Care in Pediatrics.

3. No adverse Effects: 

The best part of this study was that none of these rehab programs showed any adverse effects on children, be it long-term or short-term.

4. Positive Emotional Reactions: 

A moderate reduction in anxiety and panic attacks was also observed due to such PAC programs.

5. Better Sleep Patterns: 

Due to reduced anxiety, the sleep patterns of children under PAC, was also found to become better. Also, the use of sleep medication showed a significant reduction.

6. Reduction In Treatment Costs: 

Parents who chose their kids to be put under the PAC program showed relevant signs of lower treatment costs. Even after a major operation, constant improvement in the patient leads to less re-hospitalization and post-surgical complications; hence, lesser treatment costs.

7. Ability to Cope Better: 

Since kids with chronic pain and permanent disabilities were subject to constant professional care, they showed improvement while interacting with people and coping with their daily functionalities.

The Outcomes of Long-term Post-Acute Care in Pediatrics

In the same study conducted by NCBI, such programs’ long-term effects did not show very strong results.
In another study conducted by JAMA pediatrics, the kid’s age range was between 0-9 years, and the term of care for each was at least three years. Also, the most common illness amongst the participants of this study was respiratory tract infection (RTI).

The observations were as follows:

1. No identification of definite factors that reduces the risk factors in the illness.
2. After admission to the long-term PAC program, the study observed an outbreak of influenza, urinary tract infection, and chronic comorbid conditions.
3. The percentage of re-hospitalization, within six months of discharge, in this case, was less; however, in the case of short-term PAC, children showed no signs of being admitted to hospitals again, for longer periods.

Scientists are still performing research and studies to determine strategies that control an outbreak of infections in children while they undergo Post-Acute Care In Pediatrics. For now, there is no definite study that proves the necessity of long-term PAC.

There are limitations to everything; hence, programs that offer Post-Acute Care in Pediatrics also have their restrictions on patients’ admission.

There are definite signs that show PAC centers’ requirement in Pediatrics; there are very few hospitals that follow this procedure.

Institutions are applying efforts to make this facility available to more kids who undergo severe treatment/surgery; children who have severe disabilities or suffer from chronic pain.

Hospitals should realize that care facilities are also required for children and not just for the elderly; hence, they should make provisions for the same.